{"id":1047,"date":"2025-09-16T09:00:00","date_gmt":"2025-09-16T09:00:00","guid":{"rendered":"http:\/\/www.dangeladvertising.com\/?p=1047"},"modified":"2025-09-19T15:05:12","modified_gmt":"2025-09-19T15:05:12","slug":"an-hiv-outbreak-in-maine-shows-the-risk-of-trumps-crackdown-on-homelessness-and-drug-use","status":"publish","type":"post","link":"http:\/\/www.dangeladvertising.com\/index.php\/2025\/09\/16\/an-hiv-outbreak-in-maine-shows-the-risk-of-trumps-crackdown-on-homelessness-and-drug-use\/","title":{"rendered":"An HIV Outbreak in Maine Shows the Risk of Trump\u2019s Crackdown on Homelessness and Drug Use"},"content":{"rendered":"

Penobscot County, Maine, is grappling with the largest HIV outbreak in the state\u2019s history. Home to Bangor, a city of roughly 32,000<\/a>, the county has identified 28 new cases<\/a> over nearly two years. That\u2019s seven times the typical number for that length of time. Nearly all cases are among people who use drugs and are homeless.<\/p>\n

Public health experts and local advocates say the outbreak is fueled by a confluence of on-the-ground factors: the sidelining and closing of programs that distributed sterile syringes to people who use drugs, a shortage of medical providers focused on HIV, and the clearing of the city\u2019s largest homeless encampment, which upended care for newly diagnosed people living there.<\/p>\n

But those issues may not remain local for long.<\/p>\n

The Trump administration is pushing similar tactics nationwide. In a recent executive order<\/a>, Trump called for defunding programs that engage in harm reduction \u2014 a broad term that encompasses many public health interventions, including syringe services, aimed at keeping people who use drugs alive. Such efforts are sometimes controversial, with critics saying they enable illegal activity. The executive order also supports forcing homeless people off the street and into treatment. This comes after the administration cut or delayed funding for various addiction<\/a> and HIV-related<\/a> programs and hollowed out<\/a> federal agencies focused on these topics<\/a>.<\/p>\n

<\/p>\n

The administration says its approach will increase public safety, but decades of research<\/a> suggest otherwise. Many advocates and researchers warn these efforts could spark more outbreaks like the one in Bangor.<\/p>\n

\u201cThat feels inevitable,\u201d said Laura Pegram, director of Drug User Health<\/a> for NASTAD, an association of public health officials who administer HIV and hepatitis programs.<\/p>\n

She said people who use drugs face a trifecta of risks: HIV, hepatitis C, and overdose. \u201cAcross the country, I think we\u2019ll start to see those three things starting to be on the rise again.\u201d<\/p>\n

\u201cThat will be incredibly costly,\u201d she added \u2014 in dollars and \u201cin a real human way.\u201d<\/p>\n

Outbreaks that start among people who use drugs can easily spread to those who don\u2019t.<\/p>\n

An HIV Outbreak<\/strong><\/p>\n

The first HIV case in Bangor\u2019s current outbreak appeared in October 2023<\/a>, well before Trump\u2019s return to the presidency.<\/p>\n

Puthiery Va, director of Maine\u2019s public health department<\/a>, attributed the emergence to the opioid epidemic, housing shortages, and the greater Bangor area\u2019s sparse health care services.<\/p>\n

Local advocates highlighted an additional, acute factor: supply shortages at the region\u2019s largest syringe services program and its subsequent closure.<\/p>\n

A nonprofit that provided health care and social services to people who use drugs, Health Equity Alliance, or HEAL, distributed more than half a million<\/a> sterile needles annually.<\/p>\n

Like other such programs nationwide, its goal was to prevent the spread of infectious disease that can occur if people share needles to inject drugs.<\/p>\n

However, financial struggles and mismanagement led to severe shortages in recent years. Former HEAL executive director Josh D\u2019Alessio acknowledged such issues, telling KFF Health News, \u201cWe did run out of syringes\u201d at times or limit how many participants could take. Several of these shortages struck in the fall of 2023, leading HEAL staffers to suggest a link to the first HIV case.<\/p>\n

The Future of Harm Reduction<\/strong><\/p>\n

Research suggests a strong connection between past HIV outbreaks among people who use drugs and lack of access to sterile needles, said Thomas Stopka<\/a>, an epidemiologist at Tufts University School of Medicine.<\/p>\n

A 2015 outbreak in Scott County, Indiana<\/a>, and one in the Merrimack Valley of Massachusetts<\/a> a few years later were curbed only after syringe services programs ramped up<\/a>, he said. If such programs had existed sooner in Scott County, more than a hundred infections could have been prevented, one study suggested<\/a>.<\/p>\n

Va, who leads the Maine Center for Disease Control and Prevention, said she considers the shortage of syringe services in the Bangor area to be a factor in the outbreak but not the primary cause.<\/p>\n

Stopka said the best practice during an outbreak \u201cis to amplify access to sterile syringes.\u201d<\/p>\n

But Trump\u2019s recent executive order links harm-reduction programs to crime, saying such efforts \u201conly facilitate illegal drug use and its attendant harm.\u201d The order doesn\u2019t name syringe services programs \u2014 which have been supported by both Democrats and Republicans<\/a> in the past \u2014 but it targets \u201csafe consumption\u201d sites, where people can use drugs under supervision. Many advocates worry<\/a> the attacks will be broader.<\/p>\n

A letter from the nation\u2019s leading addiction agency expanding on Trump\u2019s executive order said federal funds cannot be used<\/a> to buy syringes or drug pipes. However, that has been true for most of the past few decades. The letter did not address supporting general operating costs for syringe services programs.<\/p>\n

Department of Health and Human Services spokesperson Andrew Nixon told KFF Health News that the administration is committed to \u201caddressing the addiction and overdose crisis impacting communities across our nation.\u201d But he and spokespeople for the White House did not respond to specific questions about the administration\u2019s stance toward syringe services.<\/p>\n

In Bangor, some locals have raised concerns about harm reduction that echo the president\u2019s. At a March 2024 City Council meeting<\/a> \u2014 shortly after a syringe services program was newly certified by the state to operate locally \u2014 residents and business owners said they felt unsafe with the growing population of people who were homeless and using drugs. They worried syringe programs were fueling the behavior.<\/p>\n

But research suggests syringe services programs reduce discarded needles<\/a> in the community and do not<\/a> increase crime<\/a>. They can halve<\/a> new HIV and hepatitis C cases, increase entry<\/a> into addiction treatment fivefold, and save<\/a> taxpayer money<\/a>. They are also leading distributors<\/a> of overdose reversal medications, the use of which many communities \u2014 and the Trump administration \u2014 have said they support.<\/p>\n

The city ultimately decided the newly certified program, Needlepoint Sanctuary<\/a>, could not operate in prominent public parks or squares.<\/p>\n

\t\t\t\t\t<\/p>\n

\t\t\t\t\t<\/p>\n

In the following months, Needlepoint ran its syringe services only at the city\u2019s largest homeless encampment, where several people had tested positive for HIV, said the group\u2019s executive director, William \u201cWillie\u201d Hurley. That ended in February when the city cleared the encampment.<\/p>\n

This summer, Needlepoint secured a private location for its syringe services but shut it down five days later when city officials raised zoning concerns<\/a>.<\/p>\n

Jennifer Gunderman<\/a>, director of Bangor\u2019s health department, said the city is trying to strike a balance between \u201cmaking services available and what the community wants.\u201d<\/p>\n

\u201cGetting the buy-in of most of the community\u201d is \u201ccritical to the future of harm reduction,\u201d she said.<\/p>\n

Other cities in Maine<\/a> and beyond<\/a> have seen backlash result in new laws that restrict how syringe services programs operate or shutter them.<\/p>\n

Gunderman said she is hoping to avoid that in Bangor.<\/p>\n

Clearing Encampments<\/strong><\/p>\n

Trump\u2019s recent executive order also calls for clearing homeless people off the street and involuntarily committing them to treatment facilities.<\/p>\n

The administration is enacting this policy in Washington, D.C., where it has bulldozed tents<\/a> and threatened homeless people with fines and jail time<\/a> if they don\u2019t leave the streets.<\/p>\n

White House spokesperson Abigail Jackson said people have the option to be taken to a shelter or receive addiction and mental health services.<\/p>\n

Similar policies have taken hold nationwide in recent years, even in liberal hubs like New York<\/a> and California<\/a>.<\/p>\n

Last year in Bangor, as a homeless encampment that had existed for several years<\/a> grew to nearly 100 residents, business owners and locals called for its clearing.<\/p>\n

Some advocates and social service providers warned that doing so could exacerbate the HIV outbreak and overdose crisis. At two City Council meetings in November, they explained<\/a> that it would be difficult to find people they served after a clearing and that scattering newly diagnosed people could spark<\/a> HIV clusters elsewhere.<\/p>\n

\u201cPlenty of people said you\u2019re going to lose track of these people,\u201d Amy Clark<\/a>, a board member for the Bangor Area Recovery Network, told KFF Health News. \u201cThey did it anyway.\u201d<\/p>\n

<\/p>\n

\u2018I\u2019m Still Alive\u2019<\/strong><\/p>\n

Two months after clearing the encampment, the city reported<\/a> not knowing the location of more than a third of the people who had lived there.<\/p>\n

Clark said it\u2019s not surprising that the city couldn\u2019t connect everyone to housing or treatment. Many people distrust these services, shelters are frequently full, and treatment services are scarce. \u201cWhere exactly are these people supposed to go?\u201d she said.<\/p>\n

City officials stressed in Council meetings and reports that they were taking a humane approach. They ramped up social services for months leading up to the clearing, connecting people to everything from housing to storage facilities and laundry.<\/p>\n

Gunderman, the city health director, said she knows the sweep wasn\u2019t ideal but that neither was crowding folks in an unsanitary encampment. \u201cIt was a situation where there weren\u2019t a lot of great answers,\u201d she said.<\/p>\n

To help track folks from the encampment and keep them engaged in HIV treatment, the city is now using about $550,000 in opioid settlement funds<\/a> to hire two case managers. (The only other local HIV medical case management program shuttered over the summer<\/a>.)<\/p>\n

\u201cWhat we know from outreach we\u2019ve been doing already is that we spend a lot of time looking for people,\u201d Gunderman said.<\/p>\n

Jason, who has been homeless for most of the past decade and tested positive for HIV this year, has seen that in action.<\/p>\n

Members of what he calls his medical team have scoured the streets for hours to find his tent and remind him to take his HIV treatment shots, he said. Some picked up prescriptions and delivered them to him.<\/p>\n

\u201cThey\u2019ve made sure I\u2019m taken care of,\u201d Jason said. (KFF Health News agreed to use only his first name to protect his privacy.)<\/p>\n

Jason believes he got the virus last year at the homeless encampment while using drugs that someone else prepared. He had tried to avoid the encampment for months. But whenever he set up his tent elsewhere, he said, police officers told him to move.<\/p>\n

When he got the diagnosis, he thought of his uncle, who died of AIDS in the 1980s.<\/p>\n

\u201cIt hurts to talk about,\u201d Jason said, \u201cbut I\u2019m still alive.\u201d<\/p>\n

After months of treatment, his viral load is now undetectable<\/a>. Over the summer, his team helped him find housing.<\/p>\n

But Jason is still struggling to find sterile needles regularly. He worries about others facing a shortage.<\/p>\n

\u201cThat\u2019s how this outbreak has been spreading more and more,\u201d Jason said. \u201cEvery time we turn around there\u2019s another case.\u201d<\/p>\n

\n

KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/p>\n

USE OUR CONTENT<\/h3>\n

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Penobscot County, Maine, is grappling with the largest HIV outbreak in the state\u2019s history. Home…<\/p>\n","protected":false},"author":1,"featured_media":1049,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[15],"tags":[],"_links":{"self":[{"href":"http:\/\/www.dangeladvertising.com\/index.php\/wp-json\/wp\/v2\/posts\/1047"}],"collection":[{"href":"http:\/\/www.dangeladvertising.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/www.dangeladvertising.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/www.dangeladvertising.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/www.dangeladvertising.com\/index.php\/wp-json\/wp\/v2\/comments?post=1047"}],"version-history":[{"count":2,"href":"http:\/\/www.dangeladvertising.com\/index.php\/wp-json\/wp\/v2\/posts\/1047\/revisions"}],"predecessor-version":[{"id":1054,"href":"http:\/\/www.dangeladvertising.com\/index.php\/wp-json\/wp\/v2\/posts\/1047\/revisions\/1054"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/www.dangeladvertising.com\/index.php\/wp-json\/wp\/v2\/media\/1049"}],"wp:attachment":[{"href":"http:\/\/www.dangeladvertising.com\/index.php\/wp-json\/wp\/v2\/media?parent=1047"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.dangeladvertising.com\/index.php\/wp-json\/wp\/v2\/categories?post=1047"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.dangeladvertising.com\/index.php\/wp-json\/wp\/v2\/tags?post=1047"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}